Sugar Pills

by Dr. Thomas deHoop – Kalispell OB/GYN

Question:   I am currently on oral contraception and a friend of mine told me that I could avoid having my period by beginning a new packet of pills on the day that I would normally be starting “sugar pills” at the end of the pack.  Is this true?

Answer:  Your friend is correct. You can take active pills continuously and avoid menses for an indefinite period of time.  Most monthly oral contraceptive  pills ( OCPs) have 21 days of active pills and 7 days of a  placebo or “sugar” pill.The function of the placebo pill is to stop all the hormonal support to the lining of the uterus so it will shed.  Continuing to take active pills ( the first 21 days) of combination ( estrogen and progesterone) OCPs beyond 21 days can extend the time between periods and be done safely.  By taking only the active pills, you support the lining of the uterus until you decide to stop for a week.  This is the idea behind several OCPs on the market that have 9 weeks of active pills and 7 days of placebo or “sugar”pills.

If you are doing this with a monthly pill, it is important that you use a pill brand that has the same amount of hormones for each of the first 21 days ( monophasic pills).  Multiphasic pills change the amount of hormones during each week of the first 21; taking the pills for more than 21 days means you will have varying amounts of hormones each week which may lead to breakthrough bleeding.  Since you will be starting a new pack every three weeks, you need to make sure you have enough pills every month.  The best way is to have your provider write a prescription for the pills to be taken continuously.  You will need 4 packs every 3 months.

Controlling the timing of when periods occur is one of the non-contraceptive benefits of oral contraceptive pills (OCPs).  Other benefits include a reduction in ovarian cancer, uterine cancer, pelvic infection, painful periods, heavy bleeding, and benign breast disease.  With monophasic pills, you can continue taking active pills for up to 6 to 9 weeks before breakthrough bleeding may occur.  Every woman responds differently and will have breakthrough bleeding after a variable amount of time. Most studies have shown that most women will not experience breakthrough bleeding up to 9 weeks of active pills.  You can extend past this, but expect that you may have some breakthrough bleeding.  If breakthrough bleeding occurs, you can stop and take the placebo pills for 7 days and start a period that will bring you back to baseline.

To make sure that the pill doesn’t fail, you should make sure that you don’t take the placebo or “sugar” pills for more than 7 days.  These pills at the end of a pack don’t have any hormones that suppress ovulation which is why a period occurs.  If you take these for more than 7 days, you increase the chance that ovulation and pregnancy can occur.

To make sure you are on the right pill, and there are no contraindications to continuous pill usage, you should discuss this with your healthcare provider before making a change.

PLEASE NOTE: This information is not intended to be medical advice.  It is general health information and does not take into account your particular health status nor is it a substitute for personal medical care.  Kalispell OB/GYN shall not be liable for any damages arising out of the use of the content herein.